This case study engages with the journey of SNEHA (Society for Nutrition, Education and Health Action), a public health non-profit organisation founded in Mumbai in 1999. India has the distinction of being witness to a long history of efforts by public-spirited healthcare professionals. Alongside treatment, their work in public health has consistently involved giving due emphasis to prevention, reducing the excessive reliance on institutional-led public health delivery, moving towards community-based approaches and giving considerable attention to maternal and child health, the bedrock of any sound public health system. The efforts of SNEHA (which means “love” or “affection”) in developing, expanding and adapting this approach amongst some of the world’s largest and dense poor and low-income urban settlements in India constitutes an important part of this history. Started with little funding, in a little over two decades, it now oversees over Rs. 29 crores of funds; and its programmes, which started as small pilot projects to gather evidence, have evolved into large interventions drawing in many individuals and institutions along the way. Public health, unlike many other spaces of developmental interventions, demands balancing affordability, quality care and credibility with little margin for error. The case engages with the ways in which intentional evolutions to its practice have allowed SNEHA to grow, in full public glare, in a rapidly urbanising agglomeration. The case also offers an opportunity for learners to reflect on how SNEHA’s organisational culture of appreciative inquiry and its adoption of technology have enabled it to hold together a team of 500 staff and over 6,000 volunteers; and how community-based models can overcome the shortage of full-time medical professionals in a resource-constrained to deliver consistently high standards of care.